Individual
REX P LAGERSTROM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4003 KRESGE WAY STE 410, LOUISVILLE, KY 40207-4652
(502) 893-7462
(502) 212-7550
Mailing address
2700 STANLEY GAULT PKWY STE 129, LOUISVILLE, KY 40223-5176
(502) 253-4900
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
24848
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
64248487
—
KY
Enumeration date
04/18/2006
Last updated
12/07/2020
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